Dr. Barbara Herbert: Fighting prescription drug abuse

Wednesday

Nov 24, 2010 at 12:01 AMNov 24, 2010 at 9:39 PM

Americans are using prescription drugs in ever-increasing numbers. According to the Centers for Disease Control and Prevention, nearly half of Americans -- 48 percent -- now take at least one prescription drug, and nearly a third -- 31 percent -- use two to four.

Dr. Barbara Herbert

Americans are using prescription drugs in ever-increasing numbers. According to the Centers for Disease Control and Prevention, nearly half of Americans -- 48 percent -- now take at least one prescription drug, and nearly a third -- 31 percent -- use two to four.

While the benefits of these medications are vast in preventing and curing disease and alleviating pain and suffering, there's a terrible downside to this explosive growth: prescription drugs are being abused more than ever before.

Prescription medications are now the second most commonly abused category of drugs, behind only marijuana. The National Institutes of Health estimates that nearly 20 percent of people in the U.S. have used prescription drugs such as painkillers, sedatives, tranquilizers or steroids for non-medical reasons.

The behavior isn't confined to any one age group. Seniors are vulnerable because they develop more painful disabilities, take so many prescriptions, and their metabolism changes with age. Among Americans 60 and older, more than 75 percent use two or more prescriptions, and 37 percent use five or more, according to the CDC.

Young people are particularly susceptible. In its first assessment of prescription drug abuse among high-school students in 2009, the CDC found that 1 in 5 high-school students has taken a prescription drug without a doctor's prescription. Pain relievers, stimulants, sedatives and tranquilizers are the most commonly abused items. Youth have easy access to them in home medicine cabinets, and because the drugs have a legitimate use, a known amount, and are prescribed by health care providers, teenagers think they're a safe way to "get high." The abuse is so widespread that the Partnership for a Drug-Free America estimates that every day 2,500 teenagers, some as young as 12, use a prescription drug to get high for the first time.

The abuse of prescription drugs is a national public health problem: there are now more deaths from prescription drug overdoses than from heroin.

Lawmakers and public health officials have stepped up efforts to combat such abuse. Prescription monitoring programs, which track prescriptions written and filled, now operate in at least 34 states. Using electronic databases, these programs support physicians who keep patients out of pain by helping to deter and prevent drug abuse. The programs can record excessive prescribing and help to prevent such activity as "doctor shopping" for prescriptions.

But more can be done. Each one of us as consumers, patients and health providers can do something about this. Here are steps to take -- and not take:

Trust your doctor when addressing an illness. If your physician knows that a prescription medication won't do anything for your condition, don't ask for one.

Ensure you're using these drugs precisely as directed. If you have any questions at all, check with your physician or pharmacist.

Store medications safely, under lock and key, if necessary, so that they won't be susceptible to misuse or theft.

Parents must be especially alert. Of youth age 12 to 17 who have abused pain relievers, 64 percent cite friends or relatives as their source, typically without their knowledge. Talk to your children about the misuse of prescription medication and the dangers it presents.

If you care for an elderly person, take all steps to see that the patient understands how and when to take their medication. Advise other family members or caretakers as well.

Proper disposal of unused or out-of-date drugs is also critically important. Here's what the experts recommend.

Bring them to a community drug take-back or household hazard waste program, if your community conducts such efforts. Recent take-back programs have been very successful in recovering these drugs and thus potentially taking them off the streets.

Do not flush drugs down the toilet unless the label says it's OK to do so. Disposal in these ways can have an adverse impact on the environment, putting drugs into ground water and drinking water supplies.

Throw in the trash only after crushing, mixing with an undesirable substance such as kitty litter or coffee grounds, and putting into a sealed container. Make sure you remove all personal identifying information from the bottle or package.

The Partnership for a Drug Free America offers more information at www.drugfree.org/notinmyhouse, including video presentations by physicians and addiction specialists. The Substance Abuse and Mental Health Services Administration at www.samhsa.gov is another fine resource.

Barbara Herbert, M.D. is medical director of the Comprehensive Addiction Program at St. Elizabeth's Medical Center in Boston. Physician Focus is a public service of the Massachusetts Medical Society. Readers should use their own judgment when seeking medical care and consult with their physician for treatment. Comments to PhysicianFocus@mms.org.

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